An emergency department nurse says it is only a matter of time before a tragic incident similar to the death of seven-year-old Aishwarya Aswath happens again.
Cathryn Davies, who was the shift coordinator the night Aishwarya died at Perth Children's Hospital, told an inquest into her death that the same issues from that night are still prevalent.
"The biggest thing is that not much has changed to be honest," Ms Davies said.
"We are still extremely busy. We are not covered enough if [resuscitation] cases come in … and it's going to happen again."
She said despite the hospital having employed more nurses since Aishwarya's death, not having a dedicated resuscitation team meant nurses could be pulled off the floor anytime there was a critical case.
"We are one of the only tertiary hospitals … that doesn't have one and it's ridiculous," she said.
The night Aishwarya died in the waiting room a nurse was called away to a resuscitation case, interrupting her assessment of the little girl.
Recommendations by the nurses' union, accepted by the Child and Adolescent Health Service (CAHS), called for the establishment of a dedicated team.
According to documents tabled in Parliament, recruitment for that dedicated team was supposed to have been completed by the end of last year.
The ABC asked CAHS if that team had been established.
But the chair of the CAHS board Rosanna Capolingua said she could not comment as it was critical the integrity of the inquest was respected.
"We await the coroner's findings and are committed to implementing any findings that come out of this coronial inquest," she said.
'Insane' patient-to-nurse ratio
Ms Davies said the number of nurses working the night Aishwarya died compared to patients they had to treat was "insane".
She said the accepted patient-to-nurse ratio was 4:1, but on some shifts she found herself with 11 patients to care for and the night Aishwarya died it was nine patients to every nurse.
"It's not sustainable," she said.
Ms Davies gave evidence there was a "massive disconnect" between the executive and the staff on the floor.
She said despite the number of nursing positions rising from 15 to 26, only around 19 were currently filled.
She said it had been common for nurses to work double shifts – and the night Aishwarya had died she was down to work an 18-hour shift.
But due to the trauma from being involved in her attempted resuscitation, she was sent home.
Another nurse tells a similar story
Another nurse working that night, Sarah Hanbury, told the inquest she only had time for a 10-minute break on her shift that night.
"There was quite a flurry, a lot of sick kids … there were significant delays in wait times," she said.
"You were only half-doing everything."
She said things had improved but agreed with counsel assisting the coroner Sarah Tyler's suggestion that there was "still a lot of work to be done".
"Efforts are being made, but not in the timeline we need them," Ms Hanbury said.
The inquest continues.
